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Mazac R, Hyyrynen M, Kaartinen NE, Männistö S, Irz X, Hyytiäinen K, Tuomisto HL, Lombardini C. Exploring tradeoffs among diet quality and environmental impacts in self-selected diets: a population-based study. Eur J Nutr 2024:10.1007/s00394-024-03366-2. [PMID: 38584247 DOI: 10.1007/s00394-024-03366-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 03/01/2024] [Indexed: 04/09/2024]
Abstract
PURPOSE Proposed sustainable diets often deviate dramatically from currently consumed diets, excluding or drastically reducing entire food groups. Moreover, their environmental sustainability tends to be measured only in terms of greenhouse gases emissions. The aim of this study was to overcome these limitations and identify a cluster of already adopted, relatively healthy diets with substantially lower environmental impacts than the average diet. We also aimed to estimate the reduction in multiple environmental impacts that could be achieved by shifting to this diet cluster and highlight possible tradeoffs among environmental impacts. METHODS The diet clusters were identified by applying energy-adjusted multiple factor analysis and hierarchical clustering to the dietary data of the National FinHealth 2017 Study (n = 5125) harmonized with life cycle assessment data on food products from Agribalyse 3.0 and Agri-Footprint using nutrient intakes and global warming potential, land use, and eutrophication of marine and freshwater systems as the active variables. RESULTS We identified five diet clusters, none of which had the highest overall diet quality and lowest impact for all four environmental indicators. One cluster, including twenty percent of the individuals in the sample was identified as a "best compromise" diet with the highest diet quality and the second lowest environmental impacts of all clusters, except for freshwater eutrophication. The cluster did not exclude any food groups, but included more fruits, vegetables, and fish and less of all other animal-source foods than average. Shifting to this cluster diet could raise diet quality while achieving significant reductions in most but not all environmental impacts. CONCLUSION There are tradeoffs among the environmental impacts of diets. Thus, future dietary analyses should consider multiple sustainability indicators simultaneously. Cluster analysis is a useful tool to help design tailored, socio-culturally acceptable dietary transition paths towards high diet quality and lower environmental impact.
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Affiliation(s)
- Rachel Mazac
- Faculty of Agriculture and Forestry, Department of Agricultural Sciences and Helsinki Institute of Sustainability Science, University of Helsinki, Helsinki, Finland.
| | - Matti Hyyrynen
- Natural Resource Institute of Finland, Helsinki, Finland
| | | | - Satu Männistö
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Xavier Irz
- Faculty of Agriculture and Forestry, Department of Economics and Management and Helsinki Institute of Sustainability Science, University of Helsinki, Helsinki, Finland
| | - Kari Hyytiäinen
- Faculty of Agriculture and Forestry, Department of Economics and Management and Helsinki Institute of Sustainability Science, University of Helsinki, Helsinki, Finland
| | - Hanna L Tuomisto
- Faculty of Agriculture and Forestry, Department of Agricultural Sciences and Helsinki Institute of Sustainability Science, Natural Resources Institute Finland (Luke), University of Helsinki, Helsinki, Finland
| | - Chiara Lombardini
- Faculty of Agriculture and Forestry, Department of Economics and Management and Helsinki Institute of Sustainability Science, University of Helsinki, Helsinki, Finland
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Leonard UM, Leydon CL, Arranz E, Kiely ME. Impact of consuming an environmentally protective diet on micronutrients: a systematic literature review. Am J Clin Nutr 2024; 119:927-948. [PMID: 38569787 DOI: 10.1016/j.ajcnut.2024.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 01/17/2024] [Accepted: 01/23/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND A global move toward consumption of diets from sustainable sources is required to protect planetary health. As this dietary transition will result in greater reliance on plant-based protein sources, the impact on micronutrient (MN) intakes and status is unknown. OBJECTIVE Evaluate the evidence of effects on intakes and status of selected MNs resulting from changes in dietary intakes to reduce environmental impact. Selected MNs of public health concern were vitamins A, D, and B12, folate, calcium, iron, iodine, and zinc. METHODS We systematically searched 7 databases from January 2011 to October 2022 and followed the PRISMA guidelines. Eligible studies had to report individual MN intake and/or status data collected in free-living individuals from the year 2000 onward and environmental outcomes. RESULTS From the 10,965 studies identified, 56 studies were included, mostly from high-income countries (n = 49). Iron (all 56) and iodine (n = 20) were the most and least reported MNs, respectively. There was one randomized controlled trial (RCT) that also provided the only biomarker data, 10 dietary intake studies, and 45 dietary modeling studies, including 29 diet optimization studies. Most studies sought to reduce greenhouse gas emissions or intake of animal-sourced foods. Most results suggested that intakes of zinc, calcium, iodine, and vitamins B12, A, and D would decrease, and total iron and folate would increase in a dietary transition to reduce environmental impacts. Risk of inadequate intakes of zinc, calcium, vitamins A, B12 and D were more likely to increase in the 10 studies that reported nutrient adequacy. Diet optimization (n = 29) demonstrated that meeting nutritional and environmental targets is technically feasible, although acceptability is not guaranteed. CONCLUSIONS Lower intakes and status of MNs of public health concern are a potential outcome of dietary changes to reduce environmental impacts. Adequate consideration of context and nutritional requirements is required to develop evidence-based recommendations. This study was registered prospectively with PROSPERO (CRD42021239713).
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Affiliation(s)
- Ursula M Leonard
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Clarissa L Leydon
- Centre for Health and Diet Research, School of Public Health, University College Cork, Cork, Ireland; Department of Agrifood Business and Spatial Analysis, Teagasc Food Research Centre, Ashtown, Dublin, Ireland
| | - Elena Arranz
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland; Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, Madrid, Spain
| | - Mairead E Kiely
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland.
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Irz X, Tapanainen H, Saarinen M, Salminen J, Sares-Jäske L, Valsta LM. Reducing the carbon footprint of diets across socio-demographic groups in Finland: a mathematical optimisation study. Public Health Nutr 2024; 27:e98. [PMID: 38436089 PMCID: PMC10993064 DOI: 10.1017/s1368980024000508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 01/22/2024] [Accepted: 02/09/2024] [Indexed: 03/05/2024]
Abstract
OBJECTIVES To characterise nutritionally adequate, climate-friendly diets that are culturally acceptable across socio-demographic groups. To identify potential equity issues linked to more climate-friendly and nutritionally adequate dietary changes. DESIGN An optimisation model minimises distance from observed diets subject to nutritional, greenhouse gas emissions (GHGE) and food-habit constraints. It is calibrated to socio-demographic groups differentiated by sex, education and income levels using dietary intake data. The environmental coefficients are derived from life cycle analysis and an environmentally extended input-output model. SETTING Finland. PARTICIPANTS Adult population. RESULTS Across all population groups, we find large synergies between improvements in nutritional adequacy and reductions in GHGE, set at one-third or half of the current level. Those reductions result mainly from the substitution of meat with cereals, potatoes and roots and the intra-category substitution of foods, such as beef with poultry in the meat category. The simulated more climate-friendly diets are thus flexitarian. Moving towards reduced-impact diets would not create major inadequacies related to protein and fatty acid intakes, but Fe could be an issue for pre-menopausal females. The initial socio-economic gradient in the GHGE of diets is small, and the patterns of adjustments to more climate-friendly diets are similar across socio-demographic groups. CONCLUSIONS A one-third reduction in GHGE of diets is achievable through moderate behavioural adjustments, but achieving larger reductions may be difficult. The required changes are similar across socio-demographic groups and do not raise equity issues. A population-wide policy to promote behavioural change for diet sustainability would be appropriate.
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Affiliation(s)
- Xavier Irz
- Department of Economics and Management, University of
Helsinki, Latokartanonkaari 5, Helsinki,
Finland
- Bioeconomy Policies and Markets Group, Natural Resources
Institute Finland, Latokartanonkaari 9, PL 2, Helsinki,
Finland
| | - Heli Tapanainen
- Department of Public Health and Welfare, Finnish Institute
for Health and Welfare, Helsinki, Finland
| | - Merja Saarinen
- Sustainability Science and Indicators Group, Natural
Resources Institute Finland, Latokartanonkaari 9, PL 2,
Helsinki, Finland
| | - Jani Salminen
- Finnish Environment Institute, Latokartanonkaari 11,
Helsinki, Finland
| | - Laura Sares-Jäske
- Department of Public Health and Welfare, Finnish Institute
for Health and Welfare, Helsinki, Finland
| | - Liisa M Valsta
- Department of Public Health and Welfare, Finnish Institute
for Health and Welfare, Helsinki, Finland
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Eustachio Colombo P, Elinder LS, Nykänen EPA, Patterson E, Lindroos AK, Parlesak A. Developing a novel optimisation approach for keeping heterogeneous diets healthy and within planetary boundaries for climate change. Eur J Clin Nutr 2024; 78:193-201. [PMID: 37990128 DOI: 10.1038/s41430-023-01368-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 11/02/2023] [Accepted: 11/08/2023] [Indexed: 11/23/2023]
Abstract
BACKGROUND AND OBJECTIVES Current dietary habits have substantial negative impacts on the health of people and the planet. This study aimed to develop a novel approach for achieving health-promoting and climate-friendly dietary recommendations for a broad range of consumers. SUBJECTS AND METHODS Hierarchical clustering analysis was combined with linear programming to design nutritionally adequate, health-promoting, climate-friendly and culturally acceptable diets using Swedish national dietary data (n = 1797). Diets were optimised for the average consumption of the total population as well as for the dietary clusters. RESULTS Three dietary clusters were identified. All optimised diets had lower shares of animal-source foods and contained higher amounts of plant-based foods. These dietary shifts reduced climate impacts by up to 53% while leaving much of the diet unchanged. The optimised diets of the three clusters differed from the optimised diet of the total population. All optimised diets differed considerably from the food-group pattern of the EAT-Lancet diet. CONCLUSIONS The novel cluster-based optimisation approach was able to generate alternatives that may be more acceptable and realistic for a sustainable diet across different groups in the population.
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Affiliation(s)
- Patricia Eustachio Colombo
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
- Centre on Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, WC1E 7HT, London, UK.
| | - Liselotte Schäfer Elinder
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Centre for Epidemiology and Community Medicine, Region Stockholm, Stockholm, Sweden
| | - Esa-Pekka A Nykänen
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Functional Foods Forum, University of Turku, Turku, Finland
| | - Emma Patterson
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- The Swedish Food Agency, Uppsala, Sweden
| | - Anna Karin Lindroos
- The Swedish Food Agency, Uppsala, Sweden
- Department of Internal Medicine and Clinical Nutrition, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Alexandr Parlesak
- Department of Nutrition, Exercise and Sports, Copenhagen University, Copenhagen, Denmark
- Personalized Nutrition, Duale Hochschule Baden-Württemberg, Heilbronn, Germany
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Lares-Michel M, Housni FE, Reyes-Castillo Z, Huertas JR, Aguilera-Cervantes VG, Michel-Nava RM. Sustainable-psycho-nutritional intervention programme for a sustainable diet (the 'NutriSOS' study) and its effects on eating behaviour, diet quality, nutritional status, physical activity, metabolic biomarkers, gut microbiota and water and carbon footprints in Mexican population: study protocol of an mHealth randomised controlled trial. Br J Nutr 2023; 130:1823-1838. [PMID: 36991478 PMCID: PMC10587386 DOI: 10.1017/s0007114523000843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 02/06/2023] [Accepted: 03/22/2023] [Indexed: 03/31/2023]
Abstract
Mexico is going through an environmental and nutritional crisis related to unsustainable dietary behaviours. Sustainable diets could solve both problems together. This study protocol aims to develop a three-stage, 15-week mHealth randomised controlled trial of a sustainable-psycho-nutritional intervention programme to promote Mexican population adherence to a sustainable diet and to evaluate its effects on health and environmental outcomes. In stage 1, the programme will be designed using the sustainable diets, behaviour change wheel and capability, opportunity, motivation, and behaviour (COM-B) models. A sustainable food guide, recipes, meal plans and a mobile application will be developed. In stage 2, the intervention will be implemented for 7 weeks, and a 7-week follow-up period in a young Mexican adults (18-35 years) sample, randomly divided (1:1 ratio) into a control group (n 50) and an experimental group (n 50), will be divided into two arms at week 8. Outcomes will include health, nutrition, environment, behaviour and nutritional-sustainable knowledge. Additionally, socio-economics and culture will be considered. Thirteen behavioural objectives will be included using successive approaches in online workshops twice a week. The population will be monitored using the mobile application consisting of behavioural change techniques. In stage 3, the effects of the intervention will be assessed using mixed-effects models on dietary intake and quality, nutritional status, physical activity, metabolic biomarkers (serum glucose and lipid profile), gut microbiota composition and dietary water and carbon footprints of the evaluated population. Improvements in health outcomes and a decrease in dietary water and carbon footprints are expected.
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Affiliation(s)
- Mariana Lares-Michel
- Institute of Nutrition and Food Technology ‘José Mataix Verdú’, Biomedical Research Center, University of Granada, Avenida del Conocimiento S/N. Parque Tecnológico de la Salud. Armilla, 18071Granada, Spain
- Instituto de Investigaciones en Comportamiento Alimentario y Nutrición (IICAN), University Center of the South, University of Guadalajara, Av. Enrique Arreola Silva 883, Col. Centro, 49000, Cd. Guzmán, Jalisco, Mexico
| | - Fatima Ezzahra Housni
- Instituto de Investigaciones en Comportamiento Alimentario y Nutrición (IICAN), University Center of the South, University of Guadalajara, Av. Enrique Arreola Silva 883, Col. Centro, 49000, Cd. Guzmán, Jalisco, Mexico
| | - Zyanya Reyes-Castillo
- Instituto de Investigaciones en Comportamiento Alimentario y Nutrición (IICAN), University Center of the South, University of Guadalajara, Av. Enrique Arreola Silva 883, Col. Centro, 49000, Cd. Guzmán, Jalisco, Mexico
| | - Jesús R. Huertas
- Institute of Nutrition and Food Technology ‘José Mataix Verdú’, Biomedical Research Center, University of Granada, Avenida del Conocimiento S/N. Parque Tecnológico de la Salud. Armilla, 18071Granada, Spain
| | - Virginia Gabriela Aguilera-Cervantes
- Instituto de Investigaciones en Comportamiento Alimentario y Nutrición (IICAN), University Center of the South, University of Guadalajara, Av. Enrique Arreola Silva 883, Col. Centro, 49000, Cd. Guzmán, Jalisco, Mexico
| | - Rosa María Michel-Nava
- Tecnológico Nacional de México, Campus Ciudad Guzmán, Avenida Tecnológico 100, Col. Centro, 49000Ciudad Guzmán, Mexico
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Gie SM, Nguyen PH, Bergeron G, Tran LM, Hoang NT, Knight F. Locally relevant food-based recommendations could increase iron and calcium intake for adolescent girls in Vietnam. Ann N Y Acad Sci 2023; 1527:97-106. [PMID: 37414089 DOI: 10.1111/nyas.15036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/08/2023]
Abstract
Unhealthy eating habits are common among adolescents in Vietnam, where transitioning food environments increasingly offer energy-dense micronutrient-poor foods. Successful behavior change approaches must be feasible and acceptable, promoting local foods that are available, accessible, and preferred. Yet, few studies have investigated the potential of food-based approaches for adolescents. We used linear programming to identify problem nutrients, local nutrient sources, and realistic food-based recommendations (FBRs) to improve nutrient intake among girls 16-22 years in Thai Nguyen, Vietnam. We then identified a reduced set of FBRs to prioritize the most critical micronutrient gaps. Calcium and iron targets could not be met in any realistic diet modeling scenario. The best set of FBRs included seven recommendations which could meet intake targets for 9 of 11 modeled micronutrients. The best reduced set of three FBRs targeting iron and calcium only-although more feasible for behavior change-was less effective at improving intake of these nutrients since fewer foods were recommended. Given the difficulty of meeting calcium and iron targets using local foods within acceptable dietary patterns, additional interventions, such as supplementation, staple food fortification, or increasing the availability of affordable calcium- and iron-rich foods, may be necessary to promote dietary adequacy for adolescent girls.
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Affiliation(s)
| | - Phuong Hong Nguyen
- International Food Policy Research Institute, Washington, DC, USA
- Thai Nguyen University of Pharmacy and Medicine, Thai Nguyen City, Vietnam
| | | | | | | | - Frances Knight
- Nutrition Division, United Nations World Food Programme, Rome, Italy
- London School of Hygiene and Tropical Medicine, London, UK
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7
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Fatemi SF, Irankhah K, Kruger J, Bruins MJ, Sobhani SR. Implementing micronutrient fortification programs as a potential practical contribution to achieving sustainable diets. NUTR BULL 2023; 48:411-424. [PMID: 37503811 DOI: 10.1111/nbu.12630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 07/12/2023] [Accepted: 07/13/2023] [Indexed: 07/29/2023]
Abstract
Due to sustainability concerns related to current diets and environmental challenges, it is crucial to have sound policies to protect human and planetary health. It is proposed that sustainable diets will improve public health and food security and decrease the food system's effect on the environment. Micronutrient deficiencies are a well-known major public health concern. One-third to half of the world's population suffers from nutrient deficiencies, which have a negative impact on society in terms of unrealised potential and lost economic productivity. Large-scale fortification with different micronutrients has been found to be a useful strategy to improve public health. As a cost-effective strategy to improve micronutrient deficiency, this review explores the role of micronutrient fortification programmes in ensuring the nutritional quality (and affordability) of diets that are adjusted to help ensure environmental sustainability in the face of climate change, for example by replacing some animal-sourced foods with nutrient-dense, plant-sourced foods fortified with the micronutrients commonly supplied by animal-sourced foods. Additionally, micronutrient fortification considers food preferences based on the dimensions of a culturally sustainable diet. Thus, we conclude that investing in micronutrient fortification could play a significant role in preventing and controlling micronutrient deficiencies, improving diets and being environmentally, culturally and economically sustainable.
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Affiliation(s)
- Seyedeh Fatemeh Fatemi
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Kiyavash Irankhah
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Johanita Kruger
- Institute of Nutritional Sciences, University of Hohenheim, Stuttgart, Germany
| | | | - Seyyed Reza Sobhani
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Perraud E, Wang J, Dussiot A, Fouillet H, Mariotti F. Identifying the most Efficient Detailed Trajectories toward Healthy Diets-A Graph-Based Analysis. J Nutr 2023; 153:2744-2752. [PMID: 37479114 DOI: 10.1016/j.tjnut.2023.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 07/11/2023] [Accepted: 07/17/2023] [Indexed: 07/23/2023] Open
Abstract
BACKGROUND Much effort has been devoted to defining healthy diets, which could lower the burden of disease and provide targets for populations. However, these target diets are far removed from current diets, so at best, the population is expected to move slowly along a trajectory. OBJECTIVE Our aim was to characterize the different possible trajectories toward a target diet and identify the most efficient one for health to point out the first dietary changes being the most urgent to implement. METHODS Using graph theory, we have developed a new method to represent in a graph all stepwise change trajectories toward a target healthy diet, with trajectories all avoiding risk of nutrient deficiency. Then, we have identified and characterized the trajectory with the highest value for long-term health. Observed male and female average diets are from the French representative survey INCA3, and target diets were set using multicriteria optimization. The best trajectories were found using the Dijkstra algorithm with the Health risk criteria based on epidemiological data. RESULTS Within ∼2.6M diets in the graphs, we found optimal trajectories that were rather similar for males and females regarding the most efficient changes in the first phase of the pathways. In particular, we found that a 1-step increase in the consumption of whole/semirefined bread (60 g) was the first step in all healthiest trajectories. In males, the subsequent decrease in red meat was immediately preceded by increases in legumes. CONCLUSIONS We show simple practical dietary changes that can be prioritized along an integral pathway that is the most efficient overall for health when transiting toward a distant healthy diet. We put forward a new method to analyze dietary strategy for public health transition and highlight the first critical steps to prioritize.
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Affiliation(s)
- Elie Perraud
- Université Paris-Saclay, AgroParisTech, INRAE, UMR PNCA, 91120, Palaiseau, France
| | - Juhui Wang
- Université Paris-Saclay, AgroParisTech, INRAE, UMR PNCA, 91120, Palaiseau, France
| | - Alison Dussiot
- Université Paris-Saclay, AgroParisTech, INRAE, UMR PNCA, 91120, Palaiseau, France
| | - Hélène Fouillet
- Université Paris-Saclay, AgroParisTech, INRAE, UMR PNCA, 91120, Palaiseau, France
| | - François Mariotti
- Université Paris-Saclay, AgroParisTech, INRAE, UMR PNCA, 91120, Palaiseau, France.
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Stern AL, Levine S, Richardson SA, Blackstone NT, Economos C, Griffin TS. Improving school lunch menus with multi-objective optimisation: nutrition, cost, consumption and environmental impacts. Public Health Nutr 2023; 26:1715-1727. [PMID: 37165566 PMCID: PMC10410403 DOI: 10.1017/s1368980023000927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 02/19/2023] [Accepted: 04/04/2023] [Indexed: 05/12/2023]
Abstract
OBJECTIVE To support school foods programmes by evaluating the relationship between nutritional quality, cost, student consumption and the environmental impacts of menus. DESIGN Using linear programming and data from previously served menu items, the relationships between the nutritional quality, cost, student consumption and the environmental impacts of lunch menus were investigated. Optimised lunch menus with the maximum potential student consumption and nutritional quality and lowest costs and environmental impacts were developed and compared with previously served menus (baseline). SETTING Boston Public Schools (BPS), Boston Massachusetts, USA. PARTICIPANTS Menu items served on the 2018-2019 BPS lunch menu (n 142). RESULTS Using single-objective models, trade-offs were observed between most interests, but the use of multi-objective models minimised these trade-offs. Compared with the current weekly menus offered, multi-objective models increased potential caloric intake by up to 27 % and Healthy Eating Index scores by up to 19 % and reduced costs and environmental impacts by up to 13 % and 71 %, respectively. Improvements were made by reducing the frequency of beef and cheese entrées and increasing the frequency of fish and legume entrées on weekly menus. CONCLUSIONS This work can be extrapolated to monthly menus to provide further direction for school districts, and the methods can be employed with different recipes and constraints. Future research should test the implementation of optimised menus in schools and consider the broader implications of implementation.
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Affiliation(s)
- Alexandra L Stern
- Tufts University Friedman School of Nutrition Science and Policy, 150 Harrison Ave, Boston, MA02111, USA
| | - Stephen Levine
- Tufts University College of Arts and Sciences, Medford, MA, USA
| | | | - Nicole Tichenor Blackstone
- Tufts University Friedman School of Nutrition Science and Policy, 150 Harrison Ave, Boston, MA02111, USA
| | - Christina Economos
- Tufts University Friedman School of Nutrition Science and Policy, 150 Harrison Ave, Boston, MA02111, USA
| | - Timothy S Griffin
- Tufts University Friedman School of Nutrition Science and Policy, 150 Harrison Ave, Boston, MA02111, USA
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10
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van Wonderen D, Melse-Boonstra A, Gerdessen JC. Iron Bioavailability Should be Considered when Modeling Omnivorous, Vegetarian, and Vegan Diets. J Nutr 2023; 153:2125-2132. [PMID: 37182693 DOI: 10.1016/j.tjnut.2023.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 05/03/2023] [Accepted: 05/10/2023] [Indexed: 05/16/2023] Open
Abstract
BACKGROUND To lower environmental impact of human food consumption, replacement of animal proteins with plant-based proteins is encouraged. However, the lower iron bioavailability of plant-based foods is rarely considered when designing healthy and sustainable diets by using diet modeling. The estimated absorbable iron content of vegetarian and vegan menu plans might therefore be too optimistic. OBJECTIVE The main aim of this study was to investigate and compare the impact of various methods to estimate absorbable iron intake on the nutritional adequacy of omnivorous, vegetarian, and vegan menu plans designed for women of reproductive age. METHODS A diet model was developed to design menu plans consisting of a selection of meals that best complied with nutritional requirements. Meals used for modeling were created based on food intake data from the National Health and Nutrition Examination Survey (NHANES). For each meal, absorbable iron concentrations were estimated by using 2 constant absorption factors (18% and 10%) and 2 diet-dependent absorption equations (Conway and Hallberg). For each absorption method and diet type, we used the diet model to design the optimal menu plan. Retrospectively, menu plans were evaluated by estimating the absorbable iron content by using the other absorption methods. RESULTS Retrospective diet-dependent absorbable iron estimates were consistently lower than estimates based on constant absorption factors. Using diet-dependent estimates increased absorbable iron by optimizing enhancer and inhibitor concentrations. CONCLUSION Iron bioavailability should be considered when modeling diets.
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Affiliation(s)
- Dominique van Wonderen
- Wageningen Economic Research, Wageningen University & Research, Wageningen, Netherlands.
| | | | - Johanna C Gerdessen
- Group Operations Research and Logistics, Wageningen University, Wageningen, Netherlands
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Nordman M, Lassen AD, Stockmarr A, van ‘t Veer P, Biesbroek S, Trolle E. Exploring healthy and climate-friendly diets for Danish adults: an optimization study using quadratic programming. Front Nutr 2023; 10:1158257. [PMID: 37396137 PMCID: PMC10307962 DOI: 10.3389/fnut.2023.1158257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 05/26/2023] [Indexed: 07/04/2023] Open
Abstract
Background A transition to healthy and sustainable diets has the potential to improve human and planetary health but diets need to meet requirements for nutritional adequacy, health, environmental targets, and be acceptable to consumers. Objective The objective of this study was to derive a nutritionally adequate and healthy diet that has the least deviation possible from the average observed diet of Danish adults while aiming for a greenhouse gas emission (GHGE) reduction of 31%, corresponding to the GHGE level of the Danish plant-rich diet, which lays the foundation for the current healthy and sustainable food-based dietary guidelines (FBDGs) in Denmark. Methods With an objective function minimizing the departure from the average observed diet of Danish adults, four diet optimizations were run using quadratic programming, with different combinations of diet constraints: (1) nutrients only (Nutri), (2) nutrients and health-based targets for food amounts (NutriHealth), (3) GHGE only (GHGE), and finally, (4) combined nutrient, health and GHGE constraints (NutriHealthGHGE). Results The GHGE of the four optimized diets were 3.93 kg CO2-eq (Nutri), 3.77 kg CO2-eq (NutriHealth) and 3.01 kg CO2-eq (GHGE and NutriHealthGHGE), compared to 4.37 kg CO2-eq in the observed diet. The proportion of energy from animal-based foods was 21%-25% in the optimized diets compared to 34% in the observed diet and 18% in the Danish plant-rich diet. Moreover, compared to the average Danish diet, the NutriHealthGHGE diet contained more grains and starches (44 E% vs. 28 E%), nuts (+230%), fatty fish (+89%), eggs (+47%); less cheese (-73%), animal-based fats (-76%), total meat (-42%); and very limited amounts of ruminant meat, soft drinks, and alcoholic beverages (all-90%), while the amounts of legumes and seeds were unchanged. On average, the mathematically optimized NutriHealthGHGE diet showed a smaller deviation from the average Danish diet compared to the Danish plant-rich diet (38% vs. 169%, respectively). Conclusion The final optimized diet presented in this study represents an alternative way of composing a nutritionally adequate and healthy diet that has the same estimated GHGE as a diet consistent with the climate-friendly FBDGs in Denmark. As this optimized diet may be more acceptable for some consumers, it might help to facilitate the transition toward more healthy and sustainable diets in the Danish population.
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Affiliation(s)
- Matilda Nordman
- National Food Institute, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Anne Dahl Lassen
- National Food Institute, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Anders Stockmarr
- Department of Applied Mathematics and Computer Science, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Pieter van ‘t Veer
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
| | - Sander Biesbroek
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
| | - Ellen Trolle
- National Food Institute, Technical University of Denmark, Kgs. Lyngby, Denmark
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12
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Fouillet H, Dussiot A, Perraud E, Wang J, Huneau JF, Kesse-Guyot E, Mariotti F. Plant to animal protein ratio in the diet: nutrient adequacy, long-term health and environmental pressure. Front Nutr 2023; 10:1178121. [PMID: 37396122 PMCID: PMC10311446 DOI: 10.3389/fnut.2023.1178121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 05/18/2023] [Indexed: 07/04/2023] Open
Abstract
Background Animal and plant protein sources have contrasting relationships with nutrient adequacy and long-term health, and their adequate ratio is highly debated. Objective We aimed to explore how the percentage of plant protein in the diet (%PP) relates to nutrient adequacy and long-term health but also to environmental pressures, to determine the adequate and potentially optimal %PP values. Methods Observed diets were extracted from the dietary intakes of French adults (INCA3, n = 1,125). Using reference values for nutrients and disease burden risks for foods, we modeled diets with graded %PP values that simultaneously ensure nutrient adequacy, minimize long-term health risks and preserve at best dietary habits. This multi-criteria diet optimization was conducted in a hierarchical manner, giving priority to long-term health over diet proximity, under the constraints of ensuring nutrient adequacy and food cultural acceptability. We explored the tensions between objectives and identified the most critical nutrients and influential constraints by sensitivity analysis. Finally, environmental pressures related to the modeled diets were estimated using the AGRIBALYSE database. Results We find that nutrient-adequate diets must fall within the ~15-80% %PP range, a slightly wider range being nevertheless identifiable by waiving the food acceptability constraints. Fully healthy diets, also achieving the minimum-risk exposure levels for both unhealthy and healthy foods, must fall within the 25-70% %PP range. All of these healthy diets were very distant from current typical diet. Those with higher %PP had lower environmental impacts, notably on climate change and land use, while being as far from current diet. Conclusion There is no single optimal %PP value when considering only nutrition and health, but high %PP diets are more sustainable. For %PP > 80%, nutrient fortification/supplementation and/or new foods are required.
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Affiliation(s)
- Hélène Fouillet
- Université Paris-Saclay, AgroParisTech, INRAE, UMR PNCA, 91120, Palaiseau, France
| | - Alison Dussiot
- Université Paris-Saclay, AgroParisTech, INRAE, UMR PNCA, 91120, Palaiseau, France
| | - Elie Perraud
- Université Paris-Saclay, AgroParisTech, INRAE, UMR PNCA, 91120, Palaiseau, France
| | - Juhui Wang
- Université Paris-Saclay, AgroParisTech, INRAE, UMR PNCA, 91120, Palaiseau, France
| | - Jean-François Huneau
- Université Paris-Saclay, AgroParisTech, INRAE, UMR PNCA, 91120, Palaiseau, France
| | - Emmanuelle Kesse-Guyot
- Université Sorbonne Paris Nord and Université Paris Cité, Inserm, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), F-93017, Bobigny, France
| | - François Mariotti
- Université Paris-Saclay, AgroParisTech, INRAE, UMR PNCA, 91120, Palaiseau, France
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13
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Grasso AC, Besselink JJF, Tyszler M, Bruins MJ. The Potential of Food Fortification as an Enabler of More Environmentally Sustainable, Nutritionally Adequate Diets. Nutrients 2023; 15:nu15112473. [PMID: 37299436 DOI: 10.3390/nu15112473] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 05/22/2023] [Accepted: 05/24/2023] [Indexed: 06/12/2023] Open
Abstract
Policies encouraging shifts towards more plant-based diets can lead to shortfalls in micronutrients typically present in animal products (B-vitamins, vitamin D, calcium, iodine, iron, selenium, zinc, and long-chain omega-3 fatty acids). We modelled the effect of fortifying foods with these critical micronutrients, with the aim of achieving nutrition and sustainability goals, using food consumption data from Dutch adults (19-30 years). Three dietary scenarios were optimized for nutritional adequacy and 2030 greenhouse gas emissions (GHGE-2030) targets, respectively, with the fewest deviations from the baseline diet: (i) the current diet (mainly vitamin A- and D-fortified margarine, iodized bread, and some calcium- and vitamin D-fortified dairy alternatives and iron- and vitamin B12-fortified meat alternatives); (ii) all plant-based alternatives fortified with critical micronutrients; and (iii) fortified bread and oils. Optimizing the current diet for nutrition and GHGE-2030 targets reduced animal-to-plant protein ratios from ~65:35, to 33:67 (women) and 20:80 (men), but required major increases in legumes and plant-based alternatives. When fortifying all plant-based alternatives and, subsequently, bread and oil, smaller dietary changes were needed to achieve nutrition and GHGE-2030 targets. Fortifying food products with critical micronutrients, ideally with complementary education on plant-based foods, can facilitate the transition to healthier and more sustainable diets.
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Affiliation(s)
| | | | | | - Maaike J Bruins
- dsm-firmenich, Taste, Texture and Health, 2613 AX Delft, The Netherlands
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14
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Poinsot R, Maillot M, Drewnowski A. Fresh Pork as Protein Source in the USDA Thrifty Food Plan 2021: A Modeling Analysis of Lowest-Cost Healthy Diets. Nutrients 2023; 15:nu15081897. [PMID: 37111116 PMCID: PMC10146423 DOI: 10.3390/nu15081897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 03/31/2023] [Accepted: 04/11/2023] [Indexed: 04/29/2023] Open
Abstract
The USDA Thrifty Food Plan (TFP) is an estimate of a lowest-cost healthy diet that meets dietary guidelines while respecting existing eating habits. In the US, the TFP provides the basis for federal food assistance. Included in the TFP are protein foods from both animal and plant sources. The present goal was to explore the place of fresh pork among protein foods in the revised TFP 2021. Our analyses used the same databases and the same quadratic programming (QP) methods as had been used by the USDA to develop the TFP 2021. Dietary intakes came from the National Health and Nutrition Examination Survey (NHANES 2015-16); nutrient composition data came from the Food and Nutrient Database for Dietary Studies (FNDDS 2015-16), and national food prices came from the 2021 TFP report. Amounts and prices were for foods as consumed. Our QP Model 1 used USDA modeling categories to replicate the TFP 2021. The non-poultry meat category was then separated into pork and beef. Model 2 examined whether the TFP 2021 algorithm would select pork or beef. Model 3 sought the lowest cost healthy diet, the same as the TFP 2021. Model 4 replaced beef and poultry with pork; whereas Model 5 replaced pork and poultry with beef. Weekly costs were calculated for a family of four and eight age-gender groups. All models met the nutrient requirements. The market basket cost for a family of four in Model 1 was USD 189.88, compared to the purchase price of USD 192.84 in the TFP 2021. In Model 2, fresh pork was selected preferentially over beef. The lowest-cost healthy food plan in Model 3 increased fresh pork to 3.4 lbs/week. Replacing beef and poultry with pork in Model 4 led to a modest decrease in the weekly cost. Replacing pork and poultry with beef in Model 5 led to a major increase in the weekly cost. We conclude, based on TFP-analogous modeling, that fresh pork is the preferred meat source, providing high-quality protein at a low cost. QP methods, as used in the TFP 2021, are a valuable tool for designing food plans that are affordable, acceptable, and nutrient-rich.
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Affiliation(s)
| | | | - Adam Drewnowski
- Center for Public Health Nutrition, University of Washington, Seattle, WA 98195, USA
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15
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Webb P, Livingston Staffier K, Lee H, Howell B, Battaglia K, Bell BM, Matteson J, McKeown NM, Cash SB, Zhang FF, Decker Sparks JL, Blackstone NT. Measurement of diets that are healthy, environmentally sustainable, affordable, and equitable: A scoping review of metrics, findings, and research gaps. Front Nutr 2023; 10:1125955. [PMID: 37077905 PMCID: PMC10106581 DOI: 10.3389/fnut.2023.1125955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 03/13/2023] [Indexed: 04/05/2023] Open
Abstract
IntroductionResearch on the impacts of dietary patterns on human and planetary health is a rapidly growing field. A wide range of metrics, datasets, and analytical techniques has been used to explore the role of dietary choices/constraints in driving greenhouse gas (GHG) emissions, environmental degradation, health and disease outcomes, and the affordability of food baskets. Many argue that each domain is important, but few have tackled all simultaneously in analyzing diet-outcome relationships.MethodsThis paper reviews studies published between January 2015 and December 2021 (inclusive) that examined dietary patterns in relation to at least two of the following four thematic pillars: (i) planetary health, including, climate change, environmental quality, and natural resource impacts, (ii) human health and disease, (iii) economic outcomes, including diet cost/affordability, and (iv) social outcomes, e.g., wages, working conditions, and culturally relevant diets. We systematically screened 2,425 publications by title and abstract and included data from 42 eligible publications in this review.ResultsMost dietary patterns used were statistically estimated or simulated rather than observed. A rising number of studies consider the cost/affordability of dietary scenarios in relation to optimized environmental and health outcomes. However, only six publications incorporate social sustainability outcomes, which represents an under-explored dimension of food system concerns.DiscussionThis review suggests a need for (i) transparency and clarity in datasets used and analytical methods; (ii) explicit integration of indicators and metrics linking social and economic issues to the commonly assessed diet-climate-planetary ecology relationships; (iii) inclusion of data and researchers from low- and middle-income countries; (iv) inclusion of processed food products to reflect the reality of consumer choices globally; and (v) attention to the implications of findings for policymakers. Better understanding is urgently needed on dietary impacts on all relevant human and planetary domains simultaneously.
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Affiliation(s)
- Patrick Webb
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
- *Correspondence: Patrick Webb,
| | - Kara Livingston Staffier
- Nutritional Epidemiology Program, Jean Mayer United States Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA, United States
| | - Hyomin Lee
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
| | - Brian Howell
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
| | - Kyra Battaglia
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
| | - Brooke M. Bell
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
| | - Julia Matteson
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
| | - Nicola M. McKeown
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
- Department of Health Science, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA, United States
| | - Sean B. Cash
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
| | - Fang Fang Zhang
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
| | - Jessica L. Decker Sparks
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
| | - Nicole Tichenor Blackstone
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
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Heerschop SN, Kanellopoulos A, Biesbroek S, van 't Veer P. Shifting towards optimized healthy and sustainable Dutch diets: impact on protein quality. Eur J Nutr 2023:10.1007/s00394-023-03135-7. [PMID: 36949232 DOI: 10.1007/s00394-023-03135-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 03/10/2023] [Indexed: 03/24/2023]
Abstract
PURPOSE To reduce the environmental impact of Western diets, a reduction of meat consumption and a substitution by plant-based protein sources is needed. This protein transition will affect the quantity and quality of dietary protein. Therefore, the aim of this study was to evaluate the protein adequacy of diets optimized for nutritional health and diet-related greenhouse gas emission (GHGE). METHODS Data from 2150 adult participants of the Dutch National Food Consumption Survey were used, with diet assessed using two non-consecutive 24 h dietary recalls. Utilizable protein of current diets per day was based on meal composition and the Protein Digestibility-Corrected Amino Acid Score and was compared to protein requirements. Optimized diets were derived as linear combinations of current diets that minimized GHGE and maximized the Dutch Healthy Diet 2015 score, with/without constraints to keep dietary change within 33% of current consumption. Protein adequacy was evaluated in both current and optimized diets. RESULTS In all age and gender strata, the healthiest diets had higher GHGE, the most sustainable diets had the lowest dietary quality, though higher than current diets, and protein adequacy remained sufficient. When limiting dietary change to 33% of current consumption, in the most promising trade-off diet GHGE was reduced by 12-16%. The current diet provided 1.4-2.2 times the required amount of utilizable protein. CONCLUSION These results suggest that a realistic aim for the next decade might be to reduce diet-related GHGE to 12-16% of the current levels without compromising protein adequacy and diet quality. To achieve global targets, upstream food system transformations are needed with subsequent dietary changes.
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Affiliation(s)
- Samantha N Heerschop
- Division of Human Nutrition and Health, Wageningen University and Research, Postbox 17, 6700 AA, Wageningen, Gelderland, The Netherlands.
| | - Argyris Kanellopoulos
- Operations Research and Logistics Group, Wageningen University and Research, Wageningen, Gelderland, The Netherlands
| | - Sander Biesbroek
- Division of Human Nutrition and Health, Wageningen University and Research, Postbox 17, 6700 AA, Wageningen, Gelderland, The Netherlands
| | - Pieter van 't Veer
- Division of Human Nutrition and Health, Wageningen University and Research, Postbox 17, 6700 AA, Wageningen, Gelderland, The Netherlands
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Masino T, Colombo PE, Reis K, Tetens I, Parlesak A. Climate-friendly, health-promoting, and culturally acceptable diets for German adult omnivores, pescatarians, vegetarians, and vegans - a linear programming approach. Nutrition 2023; 109:111977. [PMID: 36801703 DOI: 10.1016/j.nut.2023.111977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 01/14/2023] [Accepted: 01/15/2023] [Indexed: 01/22/2023]
Abstract
OBJECTIVES A frequently suggested approach to reduce greenhouse gas emissions (GHGEs) caused by food production is to reduce the intake of animal products, which can create nutritional deficiencies. This study aimed to identify culturally acceptable nutritional solutions for German adults that are both climate friendly and health promoting. METHODS Linear programming was applied to optimize the food supply for omnivores, pescatarians, vegetarians, and vegans considering nutritional adequacy, health promotion, GHGEs, affordability, and cultural acceptability by approaching German national food consumption. RESULTS Implementing dietary reference values and omitting meat (products) reduced the GHGEs by ≤52%. The vegan diet was alone in staying below the Intergovernmental Panel on Climate Change (IPCC) threshold of 1.6 kg carbon dioxide equivalents per person per day. The optimized omnivorous diet constrained to meet this goal maintained ≥50% of each baseline food and, on average, deviated from baseline by 36% for women and 64% for men. Butter, milk, meat products, and cheese were reduced by half for both sexes, whereas bread, bakery goods, milk, and meat were reduced mainly for men. The intake of vegetables, cereals, pulses, mushrooms, and fish increased by between 63% and 260% for the omnivores, compared with baseline. Besides the vegan dietary pattern, all optimized diets cost less than the baseline diet. CONCLUSIONS A linear programming approach for optimizing the German habitual diet to be healthy, affordable, and meet the IPCC GHGE threshold was possible for several dietary patterns and appears to be a feasible way forward toward including climate goals into food-based dietary guidelines.
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Affiliation(s)
- Talia Masino
- Global Nutrition and Health, University College Copenhagen, Copenhagen, Denmark; Department of Nutrition, Exercise and Sports, Copenhagen, Denmark
| | - Patricia Eustachio Colombo
- Centre on Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Kia Reis
- Global Nutrition and Health, University College Copenhagen, Copenhagen, Denmark; Department of Nutrition, Exercise and Sports, Copenhagen, Denmark
| | - Inge Tetens
- Department of Nutrition, Exercise and Sports, Copenhagen, Denmark
| | - Alexandr Parlesak
- Department of Nutrition, Exercise and Sports, Copenhagen, Denmark; Baden-Württemberg Cooperative State University (DHBW), Heilbronn, Germany.
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Rossi L, Ferrari M, Ghiselli A. The Alignment of Recommendations of Dietary Guidelines with Sustainability Aspects: Lessons Learned from Italy's Example and Proposals for Future Development. Nutrients 2023; 15:nu15030542. [PMID: 36771249 PMCID: PMC9921064 DOI: 10.3390/nu15030542] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/17/2023] [Accepted: 01/19/2023] [Indexed: 01/22/2023] Open
Abstract
The main objective of this paper is to describe the process of the inclusion of sustainability in the Italian Dietary Guidelines (IDGs). In the IDGs' sustainability chapter, particular emphasis was put on the selection of foods, recommending a plant-based diet with a large quota of vegetable proteins. Advice was also given on the selection of local seasonal products, with low growth input, such as fertilizers, artificial light and heating. Reduction of animal food was recommended, to be substituted with lower impact foods (poultry, milk, eggs and Mediterranean fish including aquaculture). Food waste was largely addressed. Recommendations were made for food purchase planning, food storage and the reuse of leftovers as strategies to reduce waste and save money. The IDGs sustainability recommendations were related to the 16 guiding principles of a sustainable healthy diet and their contribution to the achievement of the Sustainable Developing Goals was provided. The inclusion of sustainability in dietary guidelines requires a multidisciplinary approach to cover the wide range of aspects of a sustainable diet. In the IDGs, it was possible to show that practical recommendations for improving sustainability behavior can be passed on to consumers. Methodological aspects for developing recommendations are not definitive.
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Affiliation(s)
- Laura Rossi
- Council for Agricultural Research and Economics—Research Centre for Food and Nutrition (CREA–Food and Nutrition), Via Ardeatina 546, 00178 Rome, Italy
- Correspondence:
| | - Marika Ferrari
- Council for Agricultural Research and Economics—Research Centre for Food and Nutrition (CREA–Food and Nutrition), Via Ardeatina 546, 00178 Rome, Italy
| | - Andrea Ghiselli
- Italian Society of Food Science and Nutrition, Via Bu Meliana, 00195 Rome, Italy
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Interlinkages between Climate Change and Food Systems: The Impact on Child Malnutrition-Narrative Review. Nutrients 2023; 15:nu15020416. [PMID: 36678287 PMCID: PMC9865989 DOI: 10.3390/nu15020416] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 01/10/2023] [Accepted: 01/11/2023] [Indexed: 01/14/2023] Open
Abstract
The pandemics of obesity, undernutrition, and climate change represent severe threats to child health. They co-occur; interact with each other to produce sequelae at biological, psychological, or social levels; and share common underlying drivers. In this paper, we review the key issues concerning child diet and nutritional status, focusing on the interactions with climate and food systems. Inadequate infant and young child feeding practices, food insecurity, poverty, and limited access to health services are the leading causes of malnutrition across generations. Food system industrialization and globalization lead to a double burden of malnutrition, whereby undernutrition (i.e., stunting, wasting, and deficiencies in micronutrients) coexists with overweight and obesity, as well as to harmful effects on climate. Climate change and the COVID-19 pandemic are worsening child malnutrition, impacting the main underlying causes (i.e., household food security, dietary diversity, nutrient quality, and access to maternal and child health), as well as the social, economic, and political factors determining food security and nutrition (livelihoods, income, infrastructure resources, and political context). Existing interventions have the potential to be further scaled-up to concurrently address undernutrition, overnutrition, and climate change by cross-cutting education, agriculture, food systems, and social safety nets. Several stakeholders must work co-operatively to improve global sustainable nutrition.
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Toutes les classes de Nutri-Score ont leur place dans des diètes nutritionnellement adéquates. CAHIERS DE NUTRITION ET DE DIÉTÉTIQUE 2023. [DOI: 10.1016/j.cnd.2022.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Exploring culturally acceptable, nutritious, affordable and low climatic impact diet for Japanese diets: proof of concept of applying a new modelling approach using data envelopment analysis. Br J Nutr 2022; 128:2438-2452. [PMID: 35022105 PMCID: PMC9723491 DOI: 10.1017/s0007114522000095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
A future sustainable dietary pattern for Japanese is yet undefined. This study aimed to explore more sustainable Japanese diets that are nutritious, affordable and with low greenhouse gas emissions (GHGE) and particular emphasis on cultural acceptability. A newly developed data envelopment analysis (DEA) diet model was applied to 4-d dietary record data among 184 healthy Japanese men and 185 women volunteers aged 21-69 years. Alternative diets were calculated as the linear combinations of observed diets. Firstly, for each individual, four modelled diets were calculated that maximised cultural acceptability (i.e. minimise dietary change from observed diet), maximised nutritional quality assessed by the Nutrient-Rich Food Index (NRF), minimised monetary diet costs or minimised diet-related GHGE. The final modelled diet combined all four indicators. In the first four models, the largest improvement was obtained for each targeted indicator separately, while relatively small improvements or unwanted changes were observed for other indicator. When all indicators were aimed to optimise, the NRF score and diet-related GHGE were improved by 8-13 % with the lower monetary cost than observed diets, although the percentage improvement was a bit smaller than the separate models. The final modelled diets demanded increased intakes for whole grains, fruits, milk/cream/yogurt, legumes/nuts, and decreased intakes for red and processed meat, sugar/confectioneries, alcoholic and sweetened beverages, and seasonings in both sexes. In conclusion, more sustainable dietary patterns considering several indicators are possible for Japanese, while total improvement is moderate due to trade-offs between indicators and methodological limitation of DEA diet model.
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22
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Koenen MF, Balvert M, Fleuren H. Bi-objective goal programming for balancing costs vs. nutritional adequacy. Front Nutr 2022; 9:1056205. [PMID: 36590216 PMCID: PMC9798409 DOI: 10.3389/fnut.2022.1056205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 11/24/2022] [Indexed: 12/23/2022] Open
Abstract
Introduction Linear programming (LP) is often used within diet optimization to find, from a set of available food commodities, the most affordable diet that meets the nutritional requirements of an individual or (sub)population. It is, however, not always possible to create a feasible diet, as certain nutritional requirements are difficult to meet. In that case, goal programming (GP) can be used to minimize deviations from the nutritional requirements in order to obtain a near feasible diet. With GP the cost of the diet is often overlooked or taken into account using the ε-constraint method. This method does not guarantee to find all possible trade-offs between costs and nutritional deficiency without solving many uninformative LPs. Methods We present a method to find all trade-offs between any two linear objectives in a dietary LP context that is simple, does not solve uninformative LPs and does not need prior input from the decision maker (DM). This method is a bi-objective algorithm based on the NonInferior Set Estimation (NISE) method that finds all efficient trade-offs between two linear objectives. Results In order to show what type of insights can be gained from this approach, two analyses are presented that investigate the relation between cost and nutritional adequacy. In the first analysis a diet with a restriction on the exact energy intake is considered where all nutrient intakes except energy are allowed to deviate from their prescription. This analysis is especially helpful in case of a restrictive budget or when a nutritionally adequate diet is either unaffordable or unattainable. The second analysis only relaxes the exact energy intake, where the other nutrients are kept within their requirements, to investigate how the energy intake affects the cost of a diet. Here, we describe in what situations the so-called more-for-less paradox takes place, which can be induced by requiring an exact energy intake. Conclusion To the best of our knowledge, we are the first to address how to obtain all efficient trade-offs of two linear objectives in a dietary LP context and how this can be used for analyses.
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Affiliation(s)
- Melissa F. Koenen
- Zero Hunger Lab, Tilburg School of Economics and Management, Tilburg University, Tilburg, Netherlands,Department of Econometrics and Operations Research, Tilburg School of Economics and Management, Tilburg University, Tilburg, Netherlands,*Correspondence: Melissa F. Koenen
| | - Marleen Balvert
- Zero Hunger Lab, Tilburg School of Economics and Management, Tilburg University, Tilburg, Netherlands,Department of Econometrics and Operations Research, Tilburg School of Economics and Management, Tilburg University, Tilburg, Netherlands
| | - Hein Fleuren
- Zero Hunger Lab, Tilburg School of Economics and Management, Tilburg University, Tilburg, Netherlands,Department of Econometrics and Operations Research, Tilburg School of Economics and Management, Tilburg University, Tilburg, Netherlands
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Incorporating environmental and sustainability considerations into health technology assessment and clinical and public health guidelines: a scoping review. Int J Technol Assess Health Care 2022; 38:e84. [PMID: 36510398 DOI: 10.1017/s0266462322003282] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Healthcare systems account for a substantial proportion of global carbon emissions and contribute to wider environmental degradation. This scoping review aimed to summarize the evidence currently available on incorporation of environmental and sustainability considerations into health technology assessments (HTAs) and guidelines to support the National In stitute for Health and Care Excellence and analogous bodies in other jurisdictions developing theirown methods and processes. Overall, 7,653 articles were identified, of which 24 were included in this review and split into three key areas - HTA (10 studies), healthcare guidelines (4 studies), and food and dietary guidelines (10 studies). Methodological reviews discussed the pros and cons of different approaches to integrate environmental considerations into HTAs, including adjustments to conventional cost-utility analysis (CUA), cost-benefit analysis, and multicriteria decision analysis. The case studies illustrated the challenges of putting this into practice, such as lack of disaggregated data to evaluate the impact of single technologies and difficulty in conducting thorough life cycle assessments that consider the full environmental effects. Evidence was scant on the incorporation of environmental impacts in clinical practice and public health guidelines. Food and dietary guidelines used adapted CUA based on life cycle assessments, simulation modeling, and qualitative judgments made by expert panels. There is uncertainty on how HTA and guideline committees will handle trade-offs between health and environment, especially when balancing environmental harms that fall largely on society with health benefits for individuals. Further research is warranted to enable integration of environmental considerations into HTA and clinical and public health guidelines.
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Sobhani SR, Edalati S, Eini-Zinab H, Kennedy G, Omidvar N. A comparative analysis of sustainability of the usual food intakes of the Iranian population, Iranian food-based dietary guidelines, and optimized dietary models. FRONTIERS IN SUSTAINABLE FOOD SYSTEMS 2022. [DOI: 10.3389/fsufs.2022.838741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Promoting sustainable diets might contribute toward achieving sustainable development goals. Considering the importance of national food-based dietary guidelines (FBDGs), this study aimed to assess and compare the sustainability dimensions of the usual Iranian dietary intakes with sustainable optimal diets based on Iranian (2006 and 2015 versions), Mediterranean, and vegetarian FBDGs. The usual dietary intakes of Iranian households were estimated using household expenditure survey data. Diet sustainability, including environmental (water, carbon, and land) footprints, cost, and nutrient-rich food (NRF) index, was calculated for the usual diet and compared with those of different FBDGs. Using linear and goal programming, optimal food models were calculated by minimizing environmental footprints and cost and maximizing NRF simultaneously for each FBDG, while maintaining nutritional considerations recommended by the FBDGs. Replacing the usual dietary intake of Iranians with the optimal diet based on the 2016 Iranian FBDG was associated with reductions equal to 20.9% for water footprint, 22.48% for carbon footprint, 20.39% for land footprint, 31.83% for cost, and 7.64% increase in NRF index. The optimal model based on the 2016 Iran FBDG was 10% more sustainable compared with the 2005 version. Changing the usual consumption of Iranians to the optimal model based on the Mediterranean pyramid was accompanied by the highest NRF index, lower environmental footprints, and cost compared to other models. The recent Iranian FBDG, compared with the older one, was more sustainable. Considering the dimensions of a sustainable diet for future FBDG revisions is recommended.
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IUNS sustainable diets task force. Trends Food Sci Technol 2022. [DOI: 10.1016/j.tifs.2022.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Vieux F, Rémond D, Peyraud JL, Darmon N. Approximately Half of Total Protein Intake by Adults Must be Animal-Based to Meet Nonprotein, Nutrient-Based Recommendations, With Variations Due to Age and Sex. J Nutr 2022; 152:2514-2525. [PMID: 36774117 PMCID: PMC9644177 DOI: 10.1093/jn/nxac150] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 06/13/2022] [Accepted: 07/01/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Shifting towards a more plant-based diet, as promoted in Western countries, will reduce the animal protein contribution to total proteins. Such a reduction may not only impair protein adequacy, but also the adequacy in other nutrients. OBJECTIVES We determined, for different adult subpopulations, the minimum total protein levels and the minimum animal protein contributions to total proteins that are compatible with the fulfillment of all nonprotein nutrient-based recommendations. METHODS Mean nutritional contents and mean diet costs were estimated using a French, cross-sectional, representative survey for 5 French subpopulations: 1) women < 50 y; 2) women 50-64 y; 3) women ≥ 65 y; 4) men < 65 y; and 5) men ≥ 65 y. For each subpopulation, linear programming optimization was used to assess the minimum protein level (model set #1) and the minimum animal protein contribution to total proteins (model set #2) that are compatible with the fulfillment of all nutrient-based recommendations (except proteins, for which levels were analyzed as outputs). Total diet costs were not allowed to increase. Eating habits were considered in model set #2 only. RESULTS The minimum amount of protein that was theoretically compatible with the fulfillment of nutrient-based recommendations (model set #1) was below the minimum recommended protein intake for all subpopulations except women < 50 y. In model set #2, for women and men ≥ 65 y, decreasing animal protein contributions to total proteins below 55% and 60%, respectively, led to protein levels below recommended levels. For the other subpopulations (women < 50 y, women 50-64 y, and men < 65 y), the lowest animal protein contributions to total proteins compatible with a nutritionally adequate diet (including protein adequacy) were 55%, 50%, and 45%, respectively. CONCLUSIONS This study provides factual information about the animal protein contributions to total proteins compatible with meeting all nutrient-based recommendations at no additional cost, and shows that they vary between 45% and 60% depending on the group of adults considered.
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Affiliation(s)
| | - Didier Rémond
- Université Clermont Auvergne, INRAE UNH, Clermont-Ferrand, France
| | | | - Nicole Darmon
- MoISA, University of Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, IRD, Montpellier, France
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Usability of myfood24 Healthcare and Mathematical Diet Optimisation in Clinical Populations: A Pilot Feasibility Randomised Controlled Trial. Nutrients 2022; 14:nu14091768. [PMID: 35565736 PMCID: PMC9101756 DOI: 10.3390/nu14091768] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/01/2022] [Accepted: 04/04/2022] [Indexed: 02/04/2023] Open
Abstract
Monitoring nutritional intake is of clinical value, but few existing tools offer electronic dietary recording, instant nutritional analysis, and a platform connecting healthcare teams with patients that provides timely, personalised support. This feasibility randomised controlled trial tests the usability of 'myfood24 Healthcare', a dietary assessment app and healthcare professional website, in two clinical populations. Patients were recruited from a weight management programme (n21) and from a group of gastroenterology surgery outpatients (n = 27). They were randomised into three groups: standard care, myfood24, or myfood24 + diet optimisation (automated suggestions for dietary improvement). The participants were asked to record their diet at least four times over eight weeks. During the study, healthcare professionals viewed recorded dietary information to facilitate discussions about diet and nutritional targets. The participants provided feedback on usability and acceptability. A total of 48 patients were recruited, and 16 were randomised to each of the three groups. Compliance among app users (n = 32) was reasonable, with 25 (78%) using it at least once and 16 (50%) recording intake for four days or more. Among users, the mean (standard deviation) number of days used was 14.0 (17.5), and the median (interquartile range) was six (2.5-17.0) over 2 months. Feedback questionnaires were completed by only 23 of 46 participants (50%). The mean System Usability Score (n = 16) was 59 (95% confidence interval, 48-70). Patient and healthcare professional feedback indicates a need for more user training and the improvement of some key app features such as the food search function. This feasibility study shows that myfood24 Healthcare is acceptable for patients and healthcare professionals. These data will inform app refinements and its application in a larger clinical effectiveness trial.
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Mazac R, Meinilä J, Korkalo L, Järviö N, Jalava M, Tuomisto HL. Incorporation of novel foods in European diets can reduce global warming potential, water use and land use by over 80. NATURE FOOD 2022; 3:286-293. [PMID: 37118200 DOI: 10.1038/s43016-022-00489-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 03/16/2022] [Indexed: 04/30/2023]
Abstract
Global food systems face the challenge of providing healthy and adequate nutrition through sustainable means, which is exacerbated by climate change and increasing protein demand by the world's growing population. Recent advances in novel food production technologies demonstrate potential solutions for improving the sustainability of food systems. Yet, diet-level comparisons are lacking and are needed to fully understand the environmental impacts of incorporating novel foods in diets. Here we estimate the possible reductions in global warming potential, water use and land use by replacing animal-source foods with novel or plant-based foods in European diets. Using a linear programming model, we optimized omnivore, vegan and novel food diets for minimum environmental impacts with nutrition and feasible consumption constraints. Replacing animal-source foods in current diets with novel foods reduced all environmental impacts by over 80% and still met nutrition and feasible consumption constraints.
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Affiliation(s)
- Rachel Mazac
- Department of Agricultural Sciences, Faculty of Agriculture and Forestry, University of Helsinki, Helsinki, Finland.
- Helsinki Institute of Sustainability Sciences (HELSUS), University of Helsinki, Helsinki, Finland.
| | - Jelena Meinilä
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Liisa Korkalo
- Helsinki Institute of Sustainability Sciences (HELSUS), University of Helsinki, Helsinki, Finland
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Natasha Järviö
- Department of Agricultural Sciences, Faculty of Agriculture and Forestry, University of Helsinki, Helsinki, Finland
- Helsinki Institute of Sustainability Sciences (HELSUS), University of Helsinki, Helsinki, Finland
- Ruralia Institute, Faculty of Agriculture and Forestry, University of Helsinki, Mikkeli, Finland
| | - Mika Jalava
- Department of Built Environment, School of Engineering, Aalto University, Helsinki, Finland
| | - Hanna L Tuomisto
- Department of Agricultural Sciences, Faculty of Agriculture and Forestry, University of Helsinki, Helsinki, Finland
- Helsinki Institute of Sustainability Sciences (HELSUS), University of Helsinki, Helsinki, Finland
- Natural Resources Institute Finland, Helsinki, Finland
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Strategies to mitigate food safety risk while minimizing environmental impacts in the era of climate change. Trends Food Sci Technol 2022. [DOI: 10.1016/j.tifs.2022.02.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Individual Diet Optimization in French Adults Shows That Plant-Based “Dairy-like” Products May Complement Dairy in Sustainable Diets. SUSTAINABILITY 2022. [DOI: 10.3390/su14052817] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study aimed to explore the potential role of plant-based “dairy-like” products (PBDL) in sustainable diets. For each individual from a representative sample of French adults (INCA2 survey 2006–2007; n = 1816), a diet optimized to be more sustainable (nutritionally adequate while having a 30% reduced carbon impact with minimal change from the actual diet and isocaloric content) was modelled. The food content of the optimized diets was compared to actual diets, with a focus on PBDL and dairy products. The presented quantitative results focused on women. Optimized diets contained more plant-based products and less meats than actual diets. PBDL products were present in 7.3% and 55.7% of the subjects’ actual and optimized diets, respectively, increasing significantly from 7 to 48 g/day. Regarding dairy products, cheese decreased (−14 g/day), milk increased (+14 g/day), and yogurt remained constant (87 g/day) between the actual and optimized diets, such that the intake of this food group remained constant (214 g/day). Women for whom PBDL products were introduced as new foods in their optimized diets were found to be those with actual low energy intake (1755 kcal/d on average). As a complement to dairy products, fortified PBDL products may help to achieve more sustainable diets, especially for individuals with low energy intakes.
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Sustainable Diet Optimization Targeting Dietary Water Footprint Reduction—A Country-Specific Study. SUSTAINABILITY 2022. [DOI: 10.3390/su14042309] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Food production creates 70% of the total anthropogenic water footprint, and it is the main cause of water pollution. Thus, more sustainable diets could contribute to the achievement of the Sustainable Development Goals. A linear programming-based stepwise optimization was designed to create dietary water footprint-reduced, culturally acceptable, and healthier diets in the case of Hungary based on a representative dietary survey. Optimization resulted in a considerable total dietary water footprint reduction (women: 18%; men: 28%) with a moderate dietary shift (~32%). Milk and dairies (observed: ~31.5%, optimized: ~20.5%) and meats and meat products (observed: ~28.0%, optimized: 28.9%) contributed the most to the dietary water footprint. In the water footprint–healthiness synergy, the vegetables, eggs, poultries, and fermented dairies were the most beneficial, increasing in amount, while fatty dairies, foods high in added sugar, and meat products were the most non-beneficial food sub-groups, decreasing in amount in the optimized diets. The problematic nutrients to fulfill in the optimized diets were energy, dietary fibers, sodium, vitamin D, zinc, vitamin B12, calcium, iron, and potassium at the maximum water footprint reduction. The study provides supporting evidence about the dietary water footprint–healthiness synergy for the further improvement of the national food-based dietary guideline.
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Perignon M, Darmon N. Advantages and limitations of the methodological approaches used to study dietary shifts towards improved nutrition and sustainability. Nutr Rev 2022; 80:579-597. [PMID: 35142357 PMCID: PMC8829675 DOI: 10.1093/nutrit/nuab091] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Acting on diet is one of the changes required - in combination with actions on food production, transformation, and waste - to address the challenges of reducing the environmental impact of our food systems and eliminating all forms of malnutrition. The number of studies exploring how to move towards a more sustainable diet has exploded over the past decades, but there is a need to facilitate their understanding and use by policy makers and all other stakeholders possibly influencing diet sustainability. The aim of the present article is to propose a categorization of studies into 4 approaches, based on the type of methodology used to explore diet sustainability, and to highlight the principles, advantages, and limitations of each approach in order to help study users in their interpretation. The 4 approaches are: assessment of sustainability characteristics of hypothetical diets (approach 1) or existing diets (approach 2), identification of existing "positive deviants" (approach 3), and design of more sustainable diets with constrained optimization (approach 4). Specificities and key findings drawn from each approach are described, and challenges for future studies are discussed.
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Affiliation(s)
- Marlène Perignon
- MoISA, Université de Montpellier, CIHEAM-IAMM, CIRAD, INRAE, Institut Agro, IRD, Montpellier, France
| | - Nicole Darmon
- MoISA, Université de Montpellier, CIHEAM-IAMM, CIRAD, INRAE, Institut Agro, IRD, Montpellier, France
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Heerschop SN, Biesbroek S, Boshuizen HC, van't Veer P. Low Meat Consumption in the Netherlands Is Associated With Higher Intake of Fish, Nuts, Seeds, Cheese, Sweets, and Snacks: Results From a Two-Part Model. Front Nutr 2022; 8:741286. [PMID: 35155510 PMCID: PMC8825789 DOI: 10.3389/fnut.2021.741286] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 12/16/2021] [Indexed: 12/04/2022] Open
Abstract
Studies on sustainable diets show a need for replacement of animal-based foods by plant-based foods, which is also called “the protein transition.” To gain insight into the acceptability of such diet shifts, this study evaluated which current food sources people consume at varying amounts of meat consumption. The study population consisted of 4,313 participants aged 1–79 years of the Dutch National Food Consumption Survey 2012–2016, which assessed diet using two nonconsecutive 24-h dietary recalls. A two-part statistical model was used that accounts for both repeated measures and the correlation between probability and amount of consumption. Results are presented for quartiles of low to high meat consumption, by age and sex. Depending on age and sex, a higher consumption of fish (>100%), nuts and seeds (73–156%), cheese (34–111%), and sweets and snacks (28–81%) is observed in the lowest quartile of meat consumption compared to the highest. For fish, nuts, seeds, and cheese, this increase is mainly due to probability of consumption (>100%, 61–93%, and 16–64%, respectively). For sweets and snacks, the increase is mainly due to the amount of consumption (26–72%). Probability of potato consumption is 29–51% lower at low meat consumption. Vegetable consumption is lower mainly due to amount of consumption (6–29%). The results from the two-part model suggest that shifting away from a traditional Dutch high meat-vegetable-potatoes pattern is associated with higher probability of consuming fish, nuts and seeds, and cheese, but also increased amounts of sweets and snacks. This illustrates that analyzing the probability and amount part separately in relation to behavioral or physiological determinants extends our understanding of the diet according to meat consumption. These insights are important when developing realistic and acceptable food-based dietary guidelines for meat reduction.
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Derbyshire EJ, Finnigan TJ. Mycoprotein: A futuristic portrayal. FUTURE FOODS 2022. [DOI: 10.1016/b978-0-323-91001-9.00037-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Carvalho Ramos Salles de Oliveira D, Nunes Oliveira Jardim A, Perignon M, Drogue S, Darmon N, Dutra Caldas E, Verly-Jr E. Meeting nutritional adequacy in the Brazilian population increases pesticide intake without exceeding chronic safe levels. Int J Food Sci Nutr 2021; 73:538-551. [PMID: 34957904 DOI: 10.1080/09637486.2021.2017408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Achieving nutritional adequacy requires an increase in fresh foods consumption, which may increase pesticide intakes. This study aimed to identify required dietary modifications to achieve nutritional adequacy without exceeding the acceptable daily intake (ADI) for pesticides. Data from the National Dietary Survey 2017-2018 were linked to the pesticide database from the Program on Pesticide Residue Analysis in Food. We performed linear programming models to design nutritionally adequate diets constrained by food preferences for different constraints on pesticide intake at the least cost increment. Nutritional adequacy led to an increase in pesticide intakes without exceeding their ADI. Modifications in diets varied according to the model, but, in general, consisted in an increase in fruits and vegetables, dairy, and seafood, and a reduction in rice, red meat, and sugar-sweetened beverages quantities. In conclusion, meeting nutritional adequacy increases pesticide intake compared to the observed diets, without representing a health concern to consumers.
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Affiliation(s)
| | | | - Marlène Perignon
- MoISA, Univ Montpellier, CIHEAM-IAMM, CIRAD, INRAE, Institut Agro, IRD, Montpellier, France
| | - Sophie Drogue
- MoISA, Univ Montpellier, CIHEAM-IAMM, CIRAD, INRAE, Institut Agro, IRD, Montpellier, France
| | - Nicole Darmon
- MoISA, Univ Montpellier, CIHEAM-IAMM, CIRAD, INRAE, Institut Agro, IRD, Montpellier, France
| | - Eloisa Dutra Caldas
- Laboratory of Toxicology, Department of Pharmacy, University of Brasilia, Brasilia, Brazil
| | - Eliseu Verly-Jr
- Department of Epidemiology, Institute of Social Medicine, Rio de Janeiro State University, Rio de Janeiro, Brazil
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Verly E, de Oliveira DCRS, Sichieri R. Cost of healthy and culturally acceptable diets in Brazil in 2009 and 2018. Rev Saude Publica 2021; 55:7s. [PMID: 34852164 PMCID: PMC8627151 DOI: 10.11606/s1518-8787.2021055003329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 05/08/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To estimate the lowest cost of a healthy and culturally acceptable diet and to assess the evolution of its cost in the periods 2008-2009 and 2017-2018. METHODS We used data on the individual food consumption and food prices from the Pesquisas de Orçamentos Familiares (Household Budget Surveys), in the 2008-2009 and 2017-2018. The sample strata of each period were aggregated, forming 108 new strata with geographic and economic homogeneity. Linear programming models generated diets for each new stratum, considering the constraints in two models: model 1 (≥ 400g of fruits and vegetables); and model 2 (≥ 400g of fruits and vegetables, < 2300mg of sodium, sodium/potassium ratio < 1, ≥ 500mg of calcium). Each food could progressively deviate 5g from the observed consumption averages until the models found a solution in each of the strata. The objective function was to minimize the total cost of the diet. RESULTS The average observed and optimized costs were R$4.96, R$4.62 (model 1) and R$5.08 (model 2) in 2008-2009, and R$9.18, R$8.69 and R$9.87 in 2017-2018. Models 1 and 2 resulted in an increase of up to 6% and 11% in 2008-2009, and of up to 25% and 34% in 2017-2018 in the lowest income strata. The main changes observed in the two models include the reduction in the amounts of sweetened beverages, sweets, sauces, ready-to-eat foods, and an increase in fruits and vegetables, flour, and tubers. CONCLUSION The adequate amount of fruits and vegetables resulted in an increase in costs to some population strata. When the adequacy of calcium, sodium, and potassium was considered, we observed a more significant increase in cost, especially in 2017-2018.
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Affiliation(s)
- Eliseu Verly
- Universidade do Estado do Rio de JaneiroInstituto de Medicina SocialDepartamento de EpidemiologiaRio de JaneiroRJBrasilUniversidade do Estado do Rio de Janeiro. Instituto de Medicina Social. Departamento de Epidemiologia. Rio de Janeiro, RJ, Brasil
| | - Dayan Carvalho Ramos Salles de Oliveira
- Universidade do Estado do Rio de JaneiroInstituto de Medicina SocialDepartamento de EpidemiologiaRio de JaneiroRJBrasilUniversidade do Estado do Rio de Janeiro. Instituto de Medicina Social. Departamento de Epidemiologia. Rio de Janeiro, RJ, Brasil
| | - Rosely Sichieri
- Universidade do Estado do Rio de JaneiroInstituto de Medicina SocialDepartamento de EpidemiologiaRio de JaneiroRJBrasilUniversidade do Estado do Rio de Janeiro. Instituto de Medicina Social. Departamento de Epidemiologia. Rio de Janeiro, RJ, Brasil
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Kesse-Guyot E, Fouillet H, Baudry J, Dussiot A, Langevin B, Allès B, Rebouillat P, Brunin J, Touvier M, Hercberg S, Lairon D, Mariotti F, Pointereau P. Halving food-related greenhouse gas emissions can be achieved by redistributing meat consumption: Progressive optimization results of the NutriNet-Santé cohort. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 789:147901. [PMID: 34052500 DOI: 10.1016/j.scitotenv.2021.147901] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 04/27/2021] [Accepted: 05/16/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Diet-related greenhouse gas emissions (GHGe) mainly comes from animal-sourced foods. As progressive changes are more acceptable for a sustainable food transition, we aimed to identify nutritionally adequate and culturally acceptable optimized diets ensuring a gradual reduction in GHGe, using observed diet from a large sample of French adults, while considering the mode of food production (organic vs conventional farming) and the co-production link between milk and beef. MATERIAL AND METHOD Based on the consumption of 257 organic and conventional foods among 29,413 participants (75% women, age: 53.5 ± 14.0y) of the NutriNet-Santé study, we modelled optimal diets according to GHGe reduction scenarios in 5% steps, from 0 to 50% with nutritional, acceptability, and coproduct constraints, for men, premenopausal and menopausal women separately. RESULTS Gradual GHGe decrease under these constraints led to optimal diets with an overall decrease in animal foods, with marked reductions in dairy products (up to -83%), together with a stable but largely redistributed meat consumption in favor of poultry (up to +182%) and pork (up to +46%) and at the expense of ruminant meat (down to -92%). Amounts of legumes increases dramatically (up to +238%). The greater the reduction in diet-related GHGe, the lower the cumulative energy demand (about -25%) and land use (about -43%). The proportion of organic food increased from ~30% in the observed diets to ~70% in the optimized diets. CONCLUSION Our results suggest that meeting both nutrient reference value and environmental objectives of up to 50% GHGe reduction requires the reduction of animal foods together with important substitutions between animal food groups, which result in drastic reductions in beef and dairy products. Further research is required to explore alignment with long-term health value and conflict with acceptability, in particular for even greater GHGe reductions.
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Affiliation(s)
- Emmanuelle Kesse-Guyot
- Sorbonne Paris Nord University, Inserm, INRAE, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), 93017 Bobigny, France.
| | - Hélène Fouillet
- UMR PNCA, AgroParisTech, INRAE, Université Paris-Saclay, 75005 Paris, France
| | - Julia Baudry
- Sorbonne Paris Nord University, Inserm, INRAE, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), 93017 Bobigny, France
| | - Alison Dussiot
- UMR PNCA, AgroParisTech, INRAE, Université Paris-Saclay, 75005 Paris, France
| | | | - Benjamin Allès
- Sorbonne Paris Nord University, Inserm, INRAE, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), 93017 Bobigny, France
| | - Pauline Rebouillat
- Sorbonne Paris Nord University, Inserm, INRAE, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), 93017 Bobigny, France
| | - Joséphine Brunin
- Sorbonne Paris Nord University, Inserm, INRAE, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), 93017 Bobigny, France; ADEME, Agence de l'Environnement et de la Maîtrise de l'Energie), 49004 Angers, France
| | - Mathilde Touvier
- Sorbonne Paris Nord University, Inserm, INRAE, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), 93017 Bobigny, France
| | - Serge Hercberg
- Sorbonne Paris Nord University, Inserm, INRAE, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), 93017 Bobigny, France; Département de Santé Publique, Hôpital Avicenne, 93017 Bobigny, France
| | - Denis Lairon
- Aix Marseille Université, INSERM, INRAE, C2VN, 13005 Marseille, France
| | - François Mariotti
- UMR PNCA, AgroParisTech, INRAE, Université Paris-Saclay, 75005 Paris, France
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Reducing ultra-processed foods and increasing diet quality in affordable and culturally acceptable diets: a study case from Brazil using linear programming. Br J Nutr 2021; 126:572-581. [PMID: 33143759 DOI: 10.1017/s0007114520004365] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The aim was to design culturally acceptable and healthy diets with reduced energetic share of ultra-processed foods (UPF%) at no cost increment and to evaluate the impact of the change in the UPF% on diet quality. Food consumption and price data were obtained from the Household Budget Survey (n 55 970 households) and National Dietary Survey (n 32 749 individuals). Linear programming models were performed to design diets in which the mean population UPF% was reduced up to 5 % with no cost increment relative to the observed costs. The models were isoenergetic or allowed the energy content to vary according to the UPF%, and they were not constrained to nutritional goals (nutrient-free models) or maximised the compliance with dietary recommendations (nutrient-constrained models). Constraints regarding food preference were introduced in the models to obtain culturally acceptable diets. The mean population UPF% was 23·8 %. The lowest UPF% attained was approximately 10 %. The optimised diet cost was up to 20 % cheaper than the observed cost, depending on the model and the income level. In the optimised diets, the reduction in the UPF% was followed by an increase in fruits, vegetables, beans, tubers, dairy products, nuts, fibre, K, Mg, vitamin A and vitamin C in the nutrient-constrained models, compared with the observed consumption in the population. There was little variation in most nutrients across the UPF% reduction. The UPF% reduction in the nutrient-free models impacted only trans-fat and added sugar content. UPF% reduction and increase in diet quality are possible at no cost increment.
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Steenson S, Buttriss JL. Healthier and more sustainable diets: What changes are needed in high‐income countries? NUTR BULL 2021. [DOI: 10.1111/nbu.12518] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Eustachio Colombo P, Elinder LS, Lindroos AK, Parlesak A. Designing Nutritionally Adequate and Climate-Friendly Diets for Omnivorous, Pescatarian, Vegetarian and Vegan Adolescents in Sweden Using Linear Optimization. Nutrients 2021; 13:nu13082507. [PMID: 34444667 PMCID: PMC8398609 DOI: 10.3390/nu13082507] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 07/14/2021] [Accepted: 07/20/2021] [Indexed: 12/23/2022] Open
Abstract
Low-carbon diets can counteract climate change and promote health if they are nutritionally adequate, affordable and culturally acceptable. This study aimed at developing sustainable diets and to compare these with the EAT-Lancet diet. The Swedish national dietary survey Riksmaten Adolescents 2016–2017 was used as the baseline. Diets were optimized using linear programming for four dietary patterns: omnivores, pescatarians, vegetarians and vegans. The deviation from the baseline Riksmaten diet was minimized for all optimized diets while fulfilling nutrient and climate footprint constraints. Constraining the diet-related carbon dioxide equivalents of omnivores to 1.57 kg/day resulted in a diet associated with a reduction of meat, dairy products, and processed foods and an increase in potatoes, pulses, eggs and seafood. Climate-friendly, nutritionally adequate diets for pescatarians, vegetarians and vegans contained fewer foods and included considerable amounts of fortified dairy and meat substitutes. The optimized diets did not align very well with the food-group pattern of the EAT-Lancet diet. These findings suggest how to design future diets that are climate-friendly, nutritionally adequate, affordable, and culturally acceptable for Swedish adolescents with different dietary patterns. The discrepancies with the EAT diet indicate that the cultural dietary context is likely to play an important role in characterizing sustainable diets for specific populations.
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Affiliation(s)
| | - Liselotte Schäfer Elinder
- Department of Global Public Health, Karolinska Institutet, 113 65 Stockholm, Sweden;
- Centre for Epidemiology and Social Medicine, Region Stockholm, 113 65 Stockholm, Sweden
| | - Anna Karin Lindroos
- The Swedish Food Agency, 751 26 Uppsala, Sweden;
- Department of Internal Medicine and Clinical Nutrition, The Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden
| | - Alexandr Parlesak
- Baden-Wuerttemberg Cooperative State University, 74076 Heilbronn, Germany;
- Department of Nutrition, Exercise and Sports, University of Copenhagen, 1165 Copenhagen, Denmark
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Mariotti F, Havard S, Morise A, Nadaud P, Sirot V, Wetzler S, Margaritis I. Perspective: Modeling Healthy Eating Patterns for Food-Based Dietary Guidelines-Scientific Concepts, Methodological Processes, Limitations, and Lessons. Adv Nutr 2021; 12:590-599. [PMID: 33508130 PMCID: PMC8166537 DOI: 10.1093/advances/nmaa176] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 11/06/2020] [Accepted: 12/16/2020] [Indexed: 01/05/2023] Open
Abstract
The relations between dietary features and human health are varied and complex. Health-related variables are many and they have intricate relations at different and interrelated nutritional levels: nutrients, food groups, and the complex overall pattern. Food-based dietary guidelines (FBDGs) are principally designed to synthesize this information to make it available to the public. Here, we describe the method used to establish healthy eating patterns (HEPs) for the latest French FBDGs, which consists of in-depth food pattern modeling using an enhanced optimization method that gathered all aspects of HEPs. We present the novelty of this food modeling approach for FBDGs, which aims to gather information related to nutrients, food contaminants, and epidemiological relations with long-term health, and to be combined with the objective of realistic dietary patterns that deviate minimally from the prevailing diet. We draw lessons from stepwise implementation of the method and discuss its strengths, limitations, and perspectives. In light of the modeled HEPs, we discuss the importance of food grouping; of accounting for dietary habits while not precluding modeled diets that can be realistic/acceptable; and of taking into account the exposure to food contaminants. We discuss the tolerance and flexibility to be applied to certain dietary reference values for nutrients and health-based guidance values for contaminants so that HEPs can ultimately be identified, and how account can be taken of varied health-related outcomes applied to food groups. Although the approach involves all the peculiar uncertainties of numerous optimization model parameters and input data, its merit is that it offers a rationalized approach to establishing HEPs with multiple constraints and competing objectives. It is also versatile because it is possible to operationalize further dimensions of dietary patterns to favor human and planetary health.
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Affiliation(s)
- François Mariotti
- Université Paris-Saclay, AgroParisTech, INRAE, UMR PNCA, Paris, France
| | - Sabrina Havard
- Risk Assessment Department, ANSES, Maisons-Alfort, France
| | - Anne Morise
- Risk Assessment Department, ANSES, Maisons-Alfort, France
| | - Perrine Nadaud
- Risk Assessment Department, ANSES, Maisons-Alfort, France
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Grigoriadis V, Nugent A, Brereton P. Working towards a combined measure for describing environmental impact and nutritive value of foods: A review. Trends Food Sci Technol 2021. [DOI: 10.1016/j.tifs.2021.03.047] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Membré JM, Santillana Farakos S, Nauta M. Risk-benefit analysis in food safety and nutrition. Curr Opin Food Sci 2021. [DOI: 10.1016/j.cofs.2020.12.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Verly-Jr E, de Carvalho AM, Marchioni DML, Darmon N. The cost of eating more sustainable diets: A nutritional and environmental diet optimisation study. Glob Public Health 2021; 17:1073-1086. [PMID: 33720802 DOI: 10.1080/17441692.2021.1900315] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
We aim to identify the dietary changes to improve nutrition and reduce diet-related greenhouse gas emission (GHGE) simultaneously in Brazil, taking into account the heterogeneity in food habits and prices across the country. Food consumption and prices were obtained from two nationwide surveys (n = 55,970 households and 34,003 individuals). Linear programming models were performed to design optimised diets most resembling the observed diets, and meeting different sets of constraints: (i) nutritional, for preventing chronic diseases and meeting nutrient adequacy; (ii) socio-cultural: by respecting food preferences; and (iii) environmental: by reducing GHGE by steps of 10%. Moving toward a diet that meets nutritional recommendations led to a 14% to 24% cost increase and 10% to 27% GHGE reduction, depending on the stringency of the acceptability constraints. Stronger GHGE reductions were achievable (up to about 70%), with greater departure from the current diet, but not achieving calcium and potassium goals. Diet cost increment tended to be mitigated with GHGE reduction in most models, along with reductions in red meat, chicken, eggs, rice, and high-fat sugar sodium foods.
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Affiliation(s)
- Eliseu Verly-Jr
- Department of Epidemiology, Institute of Social Medicine, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | | | | | - Nicole Darmon
- MOISA, INRAE, CIHEAM-IAMM, CIRAD, Montpellier SupAgro, Université de Montpellier, Montpellier, France
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Brouzes CMC, Darcel N, Tomé D, Bourdet-Sicard R, Youssef Shaaban S, Gamal El Gendy Y, Khalil H, Ferguson E, Lluch A. Local Foods Can Increase Adequacy of Nutrients Other than Iron in Young Urban Egyptian Women: Results from Diet Modeling Analyses. J Nutr 2021; 151:1581-1590. [PMID: 33693946 PMCID: PMC8169812 DOI: 10.1093/jn/nxab021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 10/07/2020] [Accepted: 01/21/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Nutrition transition and recent changes in lifestyle in Middle Eastern countries have resulted in the double burden of malnutrition. In Egypt, 88% of urban women are overweight or obese and 50% are iron deficient. Their energy, sugar, and sodium intakes are excessive, while intakes of iron, vitamin D, and folate are insufficient. OBJECTIVE This study aimed to formulate dietary advice based on locally consumed and affordable foods and determine the need for fortified products to meet the nutrient requirements of urban Egyptian women. METHODS Food intakes were assessed using a 4-d food diary collected from 130 urban Egyptian women aged 19-30 y. Food prices were collected from modern and traditional markets to calculate diet cost. Population-based linear and goal programming analyses (Optifood tool) were used to identify "limiting nutrients" and to assess whether locally consumed foods (i.e., consumed by >5% of women) could theoretically improve nutrient adequacy at an affordable cost (i.e., less than or equal to the mean diet cost), while meeting recommendations for SFAs, sugars, and sodium. The potential of hypothetical fortified foods for improving intakes of micronutrients was also assessed. RESULTS Iron was the most limiting nutrient. Daily consumption of fruits, vegetables, milk or yogurt, meat/fish/eggs, and tahini (sesame paste) were likely to improve nutrient adequacy for 11 out of 12 micronutrients modeled. Among fortified foods tested, iron-fortified rice, milk, water, bread, or yogurt increased the minimized iron content of the modeled diet from 40% to >60% of the iron recommendation. CONCLUSIONS A set of dietary advice based on locally consumed foods, if put into practice, can theoretically meet requirements for most nutrients, except for iron for which adequacy is harder to achieve without fortified products. The acceptability of the dietary changes modeled needs evaluation before promoting them to young Egyptian women.
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Affiliation(s)
- Chloé M C Brouzes
- Université Paris-Saclay, AgroParisTech, INR AE, UMR PNCA, 75005, Paris, France
| | - Nicolas Darcel
- Université Paris-Saclay, AgroParisTech, INR AE, UMR PNCA, 75005, Paris, France
| | - Daniel Tomé
- Université Paris-Saclay, AgroParisTech, INR AE, UMR PNCA, 75005, Paris, France
| | | | | | | | | | - Elaine Ferguson
- Faculty of Epidemiology and Population Health, Department of Population Health, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, United Kingdom
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Seconda L, Fouillet H, Huneau JF, Pointereau P, Baudry J, Langevin B, Lairon D, Allès B, Touvier M, Hercberg S, Mariotti F, Kesse-Guyot E. Conservative to disruptive diets for optimizing nutrition, environmental impacts and cost in French adults from the NutriNet-Santé cohort. NATURE FOOD 2021; 2:174-182. [PMID: 37117444 DOI: 10.1038/s43016-021-00227-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Accepted: 01/18/2021] [Indexed: 04/30/2023]
Abstract
Improving the sustainability of diets requires the identification of diets that meet the nutritional requirements of populations, promote health, are within planetary boundaries, are affordable and are acceptable. Here we explore the extent to which dimensions of sustainability could be optimally aligned and identify more sustainable dietary solutions, from the most conservative to the most disruptive, among 12,166 participants of the NutriNet-Santé cohort. We aim to concomitantly lower environmental impacts (including greenhouse gas emissions, cumulative energy demand and land occupation), increase organic food consumption and study departure from observed diets (considered as a proxy for acceptability). From the most conservative to the most disruptive scenario, optimized diets were gradually richer in fruits, vegetables and soya-based products and markedly poorer in animal-based foods and fatty and sweet foods. The contribution of animal protein to total protein intake gradually decreased by 12% to 70% of the observed value. The greenhouse gas emissions from food production for the diets gradually decreased across scenarios (as a percentage of observed values) by 36-86%, land occupation for food production by 32-78% and energy demand by 28-72%. Our results offer a benchmark of scenarios of graded dietary changes against graded sustainability improvements.
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Affiliation(s)
- Louise Seconda
- Nutritional Epidemiology Research Team (EREN), Université Sorbonne Paris Nord, INSERM, IINRAE, CNAM, Epidemiology and Statistics Research Centre-University of Paris (CRESS), Bobigny, France
- ADEME (Agence de l'Environnement et de la Maîtrise de l'Energie), Angers, France
| | - Helene Fouillet
- Université Paris-Saclay, AgroParisTech, INRAE, UMR PNCA, Paris, France
| | | | | | - Julia Baudry
- Nutritional Epidemiology Research Team (EREN), Université Sorbonne Paris Nord, INSERM, IINRAE, CNAM, Epidemiology and Statistics Research Centre-University of Paris (CRESS), Bobigny, France.
| | | | - Denis Lairon
- C2VN, Faculté de Médecine de la Timone, Aix Marseille Université, INSERM, INRAE, Marseille, France
| | - Benjamin Allès
- Nutritional Epidemiology Research Team (EREN), Université Sorbonne Paris Nord, INSERM, IINRAE, CNAM, Epidemiology and Statistics Research Centre-University of Paris (CRESS), Bobigny, France
| | - Mathilde Touvier
- Nutritional Epidemiology Research Team (EREN), Université Sorbonne Paris Nord, INSERM, IINRAE, CNAM, Epidemiology and Statistics Research Centre-University of Paris (CRESS), Bobigny, France
| | - Serge Hercberg
- Nutritional Epidemiology Research Team (EREN), Université Sorbonne Paris Nord, INSERM, IINRAE, CNAM, Epidemiology and Statistics Research Centre-University of Paris (CRESS), Bobigny, France
- Public Health Department, Avicenne Hospital, Bobigny, France
| | - François Mariotti
- Université Paris-Saclay, AgroParisTech, INRAE, UMR PNCA, Paris, France
| | - Emmanuelle Kesse-Guyot
- Nutritional Epidemiology Research Team (EREN), Université Sorbonne Paris Nord, INSERM, IINRAE, CNAM, Epidemiology and Statistics Research Centre-University of Paris (CRESS), Bobigny, France
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Integration of various dimensions in food-based dietary guidelines via mathematical approaches: report of a DGE/FENS Workshop in Bonn, Germany, 23-24 September 2019. Br J Nutr 2020; 126:942-949. [PMID: 33272337 DOI: 10.1017/s0007114520004857] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
In the past, food-based dietary guidelines (FBDGs) were derived nearly exclusively by using systematic reviews on diet-health relationships and translating dietary reference values for nutrient intake into foods. This approach neglects many other implications that dietary recommendations have on society, the economy and environment. In view of pressing challenges, such as climate change and the rising burden of diet-related diseases, the simultaneous integration of evidence-based findings from different dimensions into FBDGs is required. Consequently, mathematical methods and data processing are evolving as powerful tools in nutritional sciences. The possibilities and reasons for the derivation of FBDGs via mathematical approaches were the subject of a joint workshop hosted by the German Nutrition Society (DGE) and the Federation of European Nutrition Societies (FENS) in September 2019 in Bonn, Germany. European scientists were invited to discuss and exchange on the topics of mathematical optimisation for the development of FBDGs and different approaches to integrate various dimensions into FBDGs. We concluded that mathematical optimisation is a suitable tool to formulate FBDGs finding trade-offs between conflicting goals and taking several dimensions into account. We identified a lack of evidence for the extent to which constraints and weights for different dimensions are set and the challenge to compile diverse data that suit the demands of optimisation models. We also found that individualisation via mathematical optimisation is one perspective of FBDGs to increase consumer acceptance, but the application of mathematical optimisation for population-based and individual FBDGs requires more experience and evaluation for further improvements.
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Grasso AC, Olthof MR, van Dooren C, Broekema R, Visser M, Brouwer IA. Protein for a Healthy Future: How to Increase Protein Intake in an Environmentally Sustainable Way in Older Adults in the Netherlands. J Nutr 2020; 151:109-119. [PMID: 33188431 PMCID: PMC8243602 DOI: 10.1093/jn/nxaa322] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 08/19/2020] [Accepted: 09/23/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Protein intake greater than the currently recommended amount is suggested to improve physical functioning and well-being in older adults, yet it is likely to increase diet-associated greenhouse gas emissions (GHGEs) if environmental sustainability is not considered. OBJECTIVES We aimed to identify dietary changes needed to increase protein intake while improving diet environmental sustainability in older adults. METHODS Starting from the habitual diet of 1,354 Dutch older adults (aged 56-101 y) from the Longitudinal Aging Study Amsterdam cohort, mathematical diet optimization was used to model high-protein diets with minimized departure from habitual intake in cumulative steps. First, a high-protein diet defined as that providing ≥1.2 g protein · kg body weight-1 · d-1 was developed isocalorically while maintaining or improving nutritional adequacy of the diet. Second, adherence to the Dutch food-based dietary guidelines (FBDG) was imposed. Third, a stepwise 10% GHGE reduction was applied. RESULTS Achieving a high-protein diet aligned with the FBDG without considering GHGEs required an increase in vegetables, legumes, nuts, whole grains, meat/dairy alternatives, dairy, and eggs and a reduction in total meat (for men only) and discretionary products, but it resulted in a 5% increase in GHGEs in men and 9% increase in women. When a stepwise GHGE reduction was additionally applied, increases in poultry and pork (mainly for women) and decreases in beef/lamb and processed meat were accrued, with total meat staying constant until a 50-60% GHGE reduction. Increases in whole grains, nuts, and meat/dairy alternatives and decreases in discretionary products were needed to lower GHGEs. CONCLUSIONS A high-protein diet aligned with FBDG can be achieved in concert with reductions in GHGEs in Dutch older adults by consuming no more than the recommended 500 g meat per week while replacing beef and lamb and processed meat with poultry and pork and increasing intake of diverse plant-protein sources.
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Affiliation(s)
| | - Margreet R Olthof
- Department of Health Sciences, Faculty of Science, and Amsterdam Public
Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam,
Netherlands
| | - Corné van Dooren
- Netherlands Nutrition Centre (Voedingscentrum), The Hague,
Netherlands
| | | | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, and Amsterdam Public
Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam,
Netherlands
| | - Ingeborg A Brouwer
- Department of Health Sciences, Faculty of Science, and Amsterdam Public
Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam,
Netherlands
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Benvenuti L, De Santis A. Making a Sustainable Diet Acceptable: An Emerging Programming Model With Applications to Schools and Nursing Homes Menus. Front Nutr 2020; 7:562833. [PMID: 33240916 PMCID: PMC7677360 DOI: 10.3389/fnut.2020.562833] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 09/15/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Food consumption is one of the most important drivers of the relation between human well-being and Earth's ecosystems. The current production level is difficult to sustain without compromising environmental integrity or public health. This calls for a decisive change in food consumption patterns in order to improve nutrition quality while respecting biodiversity and ecosystems. This change will produce some effect only if it is also culturally acceptable, accessible, economically fair and affordable. The design of food plans is traditionally carried out using mathematical optimization models, such as linear programming. This method has proved to be successful in providing nutritionally adequate diets while minimizing their economic and environmental impact. Nevertheless, cultural habits as well as attractiveness and variety of meals is very difficult to deal with, and no fully satisfactory way to include these issues in linear programming has been found. Objective: The aim of this paper is to move from traditional linear programming to a new programming methodology in order to cope also with acceptability in the design of meal plans. Method: Binary integer linear programming is the new modeling paradigm. In the proposed model, meal plans consist of providing the sequence and composition of daily meals over a given period of time and each meal can be composed using dishes from a given set. Therefore, instead of defining just a level of consumption of food groups or food items, the proposed model provides a realistic menu. To cope with sustainability, the energy and nutritional content of each dish is calculated together with its price and environmental impact. Furthermore, acceptability can be explicitly taken into account in a very natural way, that is bounding the daily, weekly, or total repetitions of single dishes and of dishes in the same food groups. Results: The paper reviews three successful studies with increasing complexity considering lunch plans for schools and full-board menus for nursing homes. The case studies show a great reduction of the environmental impact of the meal plans while ensuring an adequate nutritional intake, affordable prices and most importantly the plans are varied and culturally acceptable.
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Affiliation(s)
- Luca Benvenuti
- Department of Computer, Control, and Management Engineering, Sapienza University of Rome, Rome, Italy
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A Memetic Decomposition-Based Multi-Objective Evolutionary Algorithm Applied to a Constrained Menu Planning Problem. MATHEMATICS 2020. [DOI: 10.3390/math8111960] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Encouraging healthy and balanced diet plans is one of the most important action points for governments around the world. Generating healthy, balanced and inexpensive menu plans that fulfil all the recommendations given by nutritionists is a complex and time-consuming task; because of this, computer science has an important role in this area. This paper deals with a novel constrained multi-objective formulation of the menu planning problem specially designed for school canteens that considers the minimisation of the cost and the minimisation of the level of repetition of the specific courses and food groups contained in the plans. Particularly, this paper proposes a multi-objective memetic approach based on the well-known multi-objective evolutionary algorithm based on decomposition (MOEA/D). A crossover operator specifically designed for this problem is included in the approach. Moreover, an ad-hoc iterated local search (ILS) is considered for the improvement phase. As a result, our proposal is referred to as ILS-MOEA/D. A wide experimental comparison against a recently proposed single-objective memetic scheme, which includes explicit mechanisms to promote diversity in the decision variable space, is provided. The experimental assessment shows that, even though the single-objective approach yields menu plans with lower costs, our multi-objective proposal offers menu plans with a significantly lower level of repetition of courses and food groups, with only a minor increase in cost. Furthermore, our studies demonstrate that the application of multi-objective optimisers can be used to implicitly promote diversity not only in the objective function space, but also in the decision variable space. Consequently, in contrast to the single-objective optimiser, there was no need to include an explicit strategy to manage the diversity in the decision space in the case of the multi-objective approach.
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